Individual provider Active NPI

Courtney Melissa Mann, CRNA

  • Certified Registered Nurse Anesthetist
  • Farmers Branch, TX
National Provider Identifier
1669860250
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP127401 Issued in TX
Practice address
3169 Berrymeade LN
Farmers Branch, TX 75234-3729
Phone
(580) 222-6916
NPI assigned
Jan 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP127401 TX Primary

Addresses

Primary practice location

3169 Berrymeade LN
Farmers Branch, TX 75234-3729

Mailing address

3169 Berrymeade LN
Farmers Branch, TX 75234-3729
Phone (580) 222-6916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170425000053 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042538902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Plains Anesthesia PLLCGroup PAC ID 9133431935, 19 clinicians

Practice addresses (Care Compare)

1011 14TH Ave NW
Ardmore, OK 73401-1828
Phone (580) 226-1251

Hospital & facility affiliations

  • Mercy Hospital Ardmore, Inc Hospital, Ardmore, OK, CCN 370047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Great Plains Anesthesia, PLLC CurrentSince Jun 1, 2017 Accepting new patients
Southern Oklahoma Surgical Center Inc CurrentSince Jun 3, 2021 Accepting new patients
Arcadia Anesthesia PA CurrentSince Nov 12, 2016 Accepting new patients

Locations

1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658

901 12th Ave NW
Ardmore, OK 73401
Phone (580) 220-6560

2412 N Commerce St
Ardmore, OK 73401
Phone (580) 226-5000

6160 Windhaven Pkwy
Ste 220
Plano, TX 75093
Phone (972) 212-7463

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

401 W Campbell Rd
Richardson, TX 75080
Phone (940) 384-3535

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1669860250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 BERRYMEADE LN",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752343729",
            "telephone_number": "580-222-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 BERRYMEADE LN",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752343729",
            "telephone_number": "580-222-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "COURTNEY",
        "middle_name": "MELISSA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP127401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmers Branch, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.